The letter, shared exclusively with TIME, comes after HHS said it is withholding Title X funds from 16 organizations.

Pennsylvania and New Jersey have been targeted with more than $1 billion in grant terminations as of Tuesday as President Donald Trump’s administration pushes to slash government spending. The Philadelphia Inquirer is tracking the impact locally in an effort to help readers better understand how government funding is being cut or threatened.

The FDA’s Office of Strategic Programs was among the casualties in today’s early-morning layoffs that hit staff across the Department of Health and Human Services.

Employees at the Department of Health and Human Services began to receive notices of mass layoffs on Tuesday, days after HHS Secretary Robert F. Kennedy Jr. announced that 10,000 people would lose their jobs, including employees working on tobacco addiction, mental health and workplace safety.

As preventable infections like measles threaten to become endemic again in the US, researchers whose government grants were recently terminated are warning about the consequences of throttling studies looking at ways to increase vaccination.

As part of its widespread layoffs at U.S. health agencies, the Trump administration fired John Howard, the longtime head of the World Trade Center Health Program.

The U.S. Department of Health & Human Services has closed its regional Northwest office based in Seattle, according to U.S. Rep. Suzan DelBene.

The Trump administration shuts down HHS offices in Seattle, affecting local Head Start programs and community services.